Antibiotic resistance a looming, deadly global threat

Antibiotic-resistant bacteria threaten our health, and yet only a few pharmaceutical companies are still conducting research into new antibiotic drugs to bring them to market.

That's because these drugs generate too little profit to cover the high cost of research, development and distribution.

The Netherlands-based Access to Medicine Foundation is committed to ensuring that suitable medicines are available for patients worldwide, wherever possible.

The independent, nonprofit organization has said drug resistance is a major threat, and has called for more research into new antibiotics by pharmaceutical companies.

According to the German Association of Research-Based Pharmaceutical Companies (vfa), only 68 active substances are currently undergoing clinical trials worldwide, with 292 projects in the preclinical phase.

Sub-Saharan region hit hardest by antibiotic resistance

This is nowhere near enough, given the deadly increase in antibiotic resistance.

In a 2022 publication by medical journal The Lancet, the results of several studies on mortality and morbidity in cases of antimicrobial resistance were estimated to total nearly 5 million people worldwide.

It remains unclear whether the ultimate cause of these deaths were the original pathogen or antibiotic resistance.

The western sub-Saharan region is the hardest hit by this trend, but antibiotic resistance and the lack of new active substances are not confined to developing and emerging countries alone.

Industrialized countries are also struggling to overcome the problem, with the Access to Medicine Foundation urgently calling for new antibiotics and vaccines in response. However, many of the large companies are no longer researching new active ingredients and new medicines.

The majority of companies that produce antibiotics are large corporations that are often responsible for more than 200 products that they supply worldwide. If these companies were to change their strategy and stop producing antibiotics, people in middle and low-income countries in particular would lose access to these products.

The result would be deaths due to lack of medication, and not the pathogens themselves.

In low- and middle-income countries in particular, many active ingredients aren't even registered.

The Access to Medicine Foundation has identified more than 100 countries worldwide where such drugs are urgently needed. Only a few of the novel antibiotics even available in more than 10 of these countries.

As a result, the chances of new antibiotics reaching people are low.

Responsibility and transparency are key

It's just as important to discourage doctors from overusing conventional antibiotics, thereby preventing the development of resistance in the first place.

The Access to Medicine Foundation aims to influence companies to be responsible when it comes to marketing and sales, encouraging doctors to avoid prescribing antibiotics and in large quantities, or too often.

Some companies have started to share their findings on antibiotic resistance with clinics and researchers. American pharmaceutical giant Pfizer, for example, has published raw data from its internal control program in a freely accessible register.

Pharmaceutical research and manufacturing companies have also developed market strategies for drugs that have already been tested so that they can be distributed and used relatively quickly. 

Despite such small advances, the problem is far from solved. Antibiotic resistance is developing more rapidly than new antibiotics are becoming available. But a world without effective antibiotics would likely have a much higher collective cost than the investment needed for more research, development and distribution.

This article was originally written in German.